Healthcare Provider Details

I. General information

NPI: 1871769273
Provider Name (Legal Business Name): KAY MARIE ANTHONY RNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KAY MARIE HERRINGTON RNP-C

II. Dates (important events)

Enumeration Date: 05/06/2008
Last Update Date: 08/15/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 W BROADWAY
LONG BEACH CA
90802-4401
US

IV. Provider business mailing address

1803 OSTROM AVE
LONG BEACH CA
90815-3647
US

V. Phone/Fax

Practice location:
  • Phone: 562-570-7113
  • Fax:
Mailing address:
  • Phone: 562-773-5645
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License Number455355
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code363LX0001X
TaxonomyObstetrics & Gynecology Nurse Practitioner
License Number455355
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: